Provider Demographics
NPI:1497358436
Name:NEWHOUSE, MARLIN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MARLIN
Middle Name:
Last Name:NEWHOUSE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENOA HEALTHCARE
Mailing Address - Street 2:209 WEST CRISER RD SUITE 100
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22655
Mailing Address - Country:US
Mailing Address - Phone:540-692-1176
Mailing Address - Fax:540-904-4508
Practice Address - Street 1:GENOA HEALTHCARE
Practice Address - Street 2:209 WEST CRISER RD SUITE 100
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22655
Practice Address - Country:US
Practice Address - Phone:540-692-1176
Practice Address - Fax:540-904-4508
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist